John H,

Conversely, or so studies show, very few people spend a lot of time working only for money. Its usually 5 or 6 on the list of "reasons why I work where I do".

The question goes to the priority of motive. The profit motive sees no problem with doing cost benefits analysis on things like, Do we recall the care or is it cheaper to pay off the lawsuits? What is the minimum level of care we can provide to indigents before the cost of insurance/lawsuits is greater than the cost of providing the care?

Another side of the issue is to consider that while Hoover Dam was built by private companies (who made a profit), its purpose wasn't to make money. Nor were other products of the bureaucracy like the Blue Ridge Parkway or the Panama Canal.

"Senior Management" in any company, can isolate itself behind numbers. Much like running a war from well behind the lines. Its so much easier to send people out to be killed when they're just little colored pins on a map. Or numbers on a spreadsheet?

Or my favorite example of the profit motive at work. Windows Operating System (pick a version). Microsoft products are designed to make money. Sad that mediocrity can do that

troll,

The problem with leaving the issue to local governments is that health care providers are regional, national or international. With commensurate resources. In the good old days, local social controls worked fine. Because the health care providers depended entirely on the local economy. Abuses could be countered with local sanctions (formal or informal). That is no longer possible.

Governments do have a lot of redundancy. Advisedly so. How many stockholders know or are comfortable with the idea of "opportunity costs". While government, at least in Florida, must be open to the public, business can hide their little (or big) mistakes behind a wall of numbers. Most stockholders ask the question "What are the dividends?" Few ask "What would they be if all those opportunity costs and $100 dollar dinners were better controlled".

The Government has to account for every penny. In part as a matter of acting as trustee for public funds, in part because when the didn't have all the controls in place, you go things like the Teapot Dome scandal or the excesses of Tammany Hall

I'm am, btw, deeply concerned that you recognize rationality when you see it. Hardly fits you personality or intellectual abilities

Regards and Happy Holidays

John